The Ketone Bridge Between the Heart and the Bladder: How Fast Should We Go?

Autores da FMUP

• Carmen Dulce Da Silveira Brás Silva Ribeiro

  Autor

• Susana Maria De Sousa Silva Ferreira

  Autor

• Tiago Vieira Da Conceicao Antunes Lopes

  Autor

• Ana Cristina Estrela De Oliveira Charrua Cordeiro

  Autor

Participantes de fora da FMUP

• Faria-Costa, Gabriel
• Oliveira, Joao
• Vilas-Boas, Ines
• Campelo, Ines
• Silva, Elisa Azeredo

Unidades de investigação

• Biomedicina

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Metabolic syndrome (MS) is associated with both cardiovascular and bladder dysfunction. Insulin resistance (IR) and central obesity, in particular, are the main risk factors. In these patients, vicious pathological cycles exacerbate abnormal carbohydrate metabolism and sustain an inflammatory state, with serious implications for both the heart and bladder. Ketone bodies serve as an alternative energy source in this context. They are considered a ``super -fuel'' because they generate adenosine triphosphate with less oxygen consumption per molecule, thus enhancing metabolic efficiency. Ketone bodies have a positive impact on all components of MS. They aid in weight loss and glycemic control, lower blood pressure, improve lipid profiles, and enhance endothelial function. Additionally, they possess direct anti-inflammatory, antioxidant, and vasodilatory properties. A shared key player in dysfunction of both the heart and bladder dysfunction is the formation of the NLRP3 inflammasome, which ketone bodies inhibit. Interventions that elevate ketone body levels-such as fasting, a ketogenic diet, ketone supplements, and sodium -glucose cotransporter 2 inhibitors-have been shown to directly affect cardiovascular outcomes and improve lower urinary tract symptoms derived from MS. This review explores the pathophysiological basis of the benefits of ketone bodies in cardiac and bladder dysfunction.

Keywords

• Metabolic syndrome; Ketone bodies; Intermittent fasting; Ketogenic diet; SGLT2 inhibitors